Abstract :
Hypertension and diabetes mellitus are common diseases in the Kingdom of Saudi Arabia (KSA), related in part to improved living conditions and increasing rates of obesity. [1],[2],[3],[4],[5] One in five adults in the KSA has hypertension [6] and more than three million adults have diabetes.[7],[8] It is projected that the incidence of diabetes will continue to grow and that the majority of the cases will be type II diabetes. Diabetes Mellitus (DM) is a strong predictor of cardiovascular events.[9],[10] The increased risk of cardiovascular morbidity and mortality is about 2fold in men and 4-fold in women, and cardiovascular disease is the leading cause of death among diabetic patients. DM is also the most important cause of end-stage renal disease in KSA, accounting for almost 40% of the cases.[11] Diabetic retinopathy is one of the major causes of blindness in the general population.[12] Taken together, the health burden of DM is enormous. Hypertension and DM frequently coexist.[13],[14] Among type II diabetics, 40 to 50% have hypertension compared to 20% of matched nondiabetic patients. Also, hypertensive patients have a 2-fold increased risk of developing type II diabetes in their lifetime. The presence of hypertension in diabetic patients dramatically increases the rate of complications. In the United Kingdom Prospective Diabetes Study (UKPDS), for example, the incidence of any aggregate end-point related to diabetes was strongly and linearly associated with systolic blood pressure (BP) and over the range of systolic BP from less than 120 mm Hg to greater than 160 mm Hg the likelyhood of a cardiovascular event increased 2fold.[15] Additionally, the absolute event rate in diabetic patients is substantially higher than that in non-diabetic patients at the same level of BP.
